Keith Swanick (Fianna Fail)
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I thank the Minister of State for coming into the House. I express my sincere thanks to him for making the long trek from west Cork to Belmullet in north Mayo last Monday to engage with staff and patients in Belmullet District Hospital. They found it a fruitful experience. I genuinely thank the Minister of State for making the effort and recommending the preservation of the 20 acute beds in the hospital. It was an excellent decision, for which I express my thanks.

I was contacted by Councillor Michael Sheehan from Wexford about the reduction in services at New Houghton Hospital in New Ross and other community hospitals. What are the Government's plans for the future of the district hospital network in the light of unprecedented overcrowding in the acute hospital sector? We spoke about this issue the other day and Councillor Sheehan contacted me about New Houghton Hospital, formerly a fever hospital that has been lauded for its quality staff and delivery of care in the community. In the past few years, like many other district hospitals, it has become a care centre for patients with dementia and Alzheimer's disease and those suffering from chronic illnesses. At its peak, it accommodated approximately 80 patients, but with new HSE regulations and guidelines, it has been downsized to 50. However, in the past few months, I understand the HSE has not permitted the admission of any new patient. There are around 30 in the hospital. My understanding is a significant number of beds are available in the hospital that could be used to alleviate pressure in Wexford and Waterford, including in other acute HSE hospitals. The staff have been recognised as doing an excellent job, but, of course, I would expect them to be worried about the future of the facility, given the inability to admit new patients.

HIQA has noted the poor quality of the approach road and the green areas immediately around the hospital as limiting capacity for the residents, but it has also stated the care provided in the hospital is excellent. Given the cuts made by the HSE to local facilities, I am concerned that the hospital will be downgraded. The public in the locality is concerned about an even worse outcome, that it might eventually be closed. That would be a devastating blow to many families in the locality, employees and patients, particularly after the local community raised much-needed funds through Friends of the New Houghton Hospital to provide extra services, equipment and amenities such as a sensory garden.

The HSE claims that there is no demand for the 20 unoccupied beds and that any demand for services has been met by private organisations locally. The question is, as the Minister of State is aware, as we have spoken about the issue, why pay private facilities when HSE beds in the locality are available? It sounds suspiciously like the possibility that elderly healthcare services in the area will be privatised.

I have spoken about the district hospital network since I was elected to the Seanad. The Minister of State knows how passionate I am about it. The hospitals play a vital role in the delivery of a modern healthcare service. Any reduction in the services provided at New Houghton Hospital would be counter-intuitive and counter-productive and fly in the face of Government policy. As the Minister of State is aware, the district hospital network prevents admissions to the acute sector and facilitate discharges. Without a lot of investment but with appropriate investment, the district hospital network could provide extra services and prevent people, particularly the elderly, from having to travel long distances to avail of services. In doing so they often have to depend on a public transport system that is inadequate in certain parts of the country or the road network. Lateral thinking is needed. As I said to the Minister of State on Monday, outreach clinics to provide, for example, cardiac or respiratory rehabilitation services, could be held in these facilities.

I seek an update on the posittion at New Houghton Hospital. How does the Minister of State feel about the expansion of the district hospital network nationally?

Jim Daly (Cork South West, Fine Gael)
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I thank the Senator for his welcome and comments about my trip to Belmullet. It is always nice to see a familiar and friendly face when one goes on such a trip and to meet a medical officer with whom I am familiar. I thank the Senator for the courtesy he showed me during my visit.

Residential care is provided through a mix of public. voluntary and private provision. It is worth highlighting that the net budget for long-term residential care in 2019 is €985 million and that over 23,000 clients, on average, at any one time will be in receipt of financial support. Public residential care units such as New Houghton Hlospital in New Ross, County Wexford are an essential part of the healthcare infrastructure. In total, they provide about 5,000 long-stay beds, amounting to approximately 20% of the total stock of nursing home beds nationally. There are also about 2,000 short-stay community public beds. The standard of care delivered to residents in these units is generally very high, but we recognise that many public units are housed in buildings that are less than ideal in the modem context. Without them, however, many older people would not have access to the care they need. It is important, therefore, that we upgrade the public bed stock. That is the aim of the five-year capital investment programme for community nursing units which was announced in 2016. It provides the framework to allow for an enhanced programme to replace, upgrade and refurbish these care facilities, as appropriate.

The HSE is responsible for the delivery of health and personal social services, including the facility at New Houghton Hospital. HSE Community Health Organisation 5 which includes County Wcx lord is committed to delivering services for older persons through a community-based approach that supports older people to live in their own homes and communities and, when needed, residential care centres such as New Houghton Hospital. The hospital which dates from the 1970s is registered with HIQA as a residential long-stay unit, with a maximum of 42 beds. Services provided include long-term care, dementia care, rehabilitation, convalescence and respite, palliative and end-of-life care services. The HSE has informed the Department that the hospital has an excellent reputation locally as a care facility, that the welfare of residents is a priority for staff and management and that they are deeply appreciative of the support the hospital receives from families and the wider community. However, the HSE has also informed my Department that demand for beds at the hospital has decreased, in part because of the availability of residential beds in new facilities in the New Ross area. I have requested more detailed information from the HSE in that regard in order that my officials can properly evaluate the situation. I will be happy to update the House again in due course.

In addition, the HSE has experienced challenges in recruiting and retaining required staffing. As a result and to continue to provide quality care, while at the same time providing additional personal and communal space for residents in line with regulatory requirements, in recent months the number of operational beds in the hospital has decreased to 31. In line with usual processes, the HSE will continue to review all of its services to ensure the continued provision of high quality, value for money residential care, with the older person at the centre of all decisions made.

Keith Swanick (Fianna Fail)
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I thank the Minister of State for his comprehensive reply. I am somewhat heartened that he might come back to us with further updates because for the HSE to pay a private facility to look after patients, usually at very high cost, at a time when there are 11 unfilled beds in New Houghton Hospital is nonsensical. Families, patients, employees and local representatives are very concerned. I look forward to liaising with the Minister of State on this matter in the coming weeks.